10th Decile Project | Housed Patients Result in Avoidance of Significant Public and Hospital Costs

Posted on October 26, 2017 at 8:47 pm


This study evaluates outcomes from April 2011 to May 2013 for 163 hospital patients screened by the 10th Decile Project in Los Angeles, which works with hospitals to identify the 10 percent of homeless patients with the highest public and hospital costs – the 10th decile – and provide immediate services for placing these individuals into permanent supportive housing. This is affordable housing that provides access to health and social services, such as mental health and addiction therapy, medical care, and case management. The triage tools that are used for screening employ accurate, simple to use statistical models that analyze information about individuals that is available in hospitals, jails and homeless service agencies affiliated with medical clinics to identify the one-tenth of homeless persons with the highest public costs and the acute ongoing crises that create those high costs. Because there are multiple paths into this highest-cost group, ranging from young persons with psychoses who are publicly disruptive to older persons are simply very sick, each tool uses a cluster of statistical models specifically designed to assess risk factors for different age and gender groups. An analysis of cost outcomes shows that housing 10th decile patients resulted in avoidance of significant public and hospital costs.

  • For the 10th decile patients studied in this evaluation who obtained housing, total annual average public and hospital costs per person are estimated to have decreased from $63,808 when homeless to $16,913 when housed – excluding housing subsidy costs.
  • Total health care costs, including jail medical and mental health care, are estimated to have declined an average of 72 percent, from $58,962 to $16,474 per person.

Taking costs for housing subsidies and supportive services into account, every $1 dollar in local funds spent to house and support 10th decile patients is estimated to reduce public and hospital costs for the evaluation population that was housed by $2 in the first year and $6 in subsequent years.

Read the full report here: